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Modern Wisdom

#1068 - Dr Peter Salerno - How Narcissists Hijack Your Brain

07 Mar 2026

Transcription

Chapter 1: Why are narcissists so manipulative?

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How do you describe what you do? Someone hasn't met you before. They don't know much about you. You're at a cocktail party. How do you describe what you do? I mean, my work focuses on, I mean, I'm a psychotherapist. That's kind of like my trade. I'm licensed as a psychotherapist. I have a a doctorate in psychology. So my background is in psychology and mental health.

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I would say what I do specifically is, um, I do extensive research on the etiology or cause of personality disorders. Like that's the, that's the type of diagnosis that I specialize in assessing understanding. But one of the reasons I do it is actually not necessarily to treat personality disorders. I do it so that I help people understand, um,

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In relationships where there's a personality disorder, there's often toxicity and conflict and strife and abuse, right? And so what I do is I help people restore what I would call their reality confidence following a toxic relationship. Because in these relationships, what happens is the individual who is the victim of somebody who is intentionally

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manipulative, deceptive, controlling, what happens is the victim loses their sense of what's actually true and real and what's actually being manipulated. And so I help people following these types of

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high conflict or problematic abusive relationships kind of get their reality confidence back and one of the ways I do that is by resolving what I call traumatic cognitive dissonance which is what happens to the brain when you're forced to hold two contradictory realities at the same time because someone is trying to convince you that two things could be true at the same time when they can't be and so

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when I'm consulting with people professionally, I'm helping them regain their understanding of what's actually real, what happened to them, and what they were convinced happened to them because it was convenient for somebody else if they believed that. So it's almost like people that have spent a good bit of time intimately close to these other people, they're

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Reality gets warped around them to the point where it's difficult for them to re-enter normal reality without the old version creeping back in. Correct. Yeah. And one of the reasons for that is because the individual who is the manipulative person has done such an exceptional job of making a lot of the deception and the evidence invisible.

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So it's not like there's somebody overtly trying to manipulate you and you're aware of it, right? Like it's not like there's somebody saying, hey, I want you to buy this product from me. Here's why I think it'll improve your life. and then they pressure you, it's actually more like, no, I'm not actually up to anything.

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You're free to come and go as you please in this arrangement, all while underneath the surface, covertly trying to gain an advantage over this person for selfish reasons, exploitative reasons. And so even if the relationship has ended, they still might perceive the relationship even years or decades later in a way that's not accurate because their reality was distorted

Chapter 2: How can you spot a narcissist early?

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So we have one of the main ones that's sort of like an umbrella term is what we refer to as antagonism. Antagonism is a personality trait where people are oftentimes intentionally putting themselves at odds with another person or they're putting two other people at odds with one another. literally to create drama, to create conflict, to escalate problems rather than solve them.

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So an example of antagonism is something that we refer to as like triangulation. So one person is intentionally going to tell another person something about someone else to create a rift. And then they're going to deny that they did that. And so now the two people that didn't even speak could be having thoughts and perceptions about each other based on this other person.

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That could be completely a fabrication. It could just be a lie. And now those two people are at odds with one another and they haven't even communicated necessarily. It's just this other person is deciding I'm going to create a rift in here because it might benefit them for those two people to not get along.

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And so they're gonna strategically create a problem in that dynamic and then deny it, ever have it. I didn't even know antagonism was a personality trait or a potential personality type. I don't know. I mean, I've thought about somebody that is antagonistic. You know that, but I didn't realize that it would be something more definable, something that had its own little bucket.

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Yeah, and that's actually a big bucket because what's underneath antagonism is things like grandiosity, which we see in narcissism. I'm sure you're familiar with that term. It's a big popular term. Most people who get accused of being narcissistic, what they're actually being accused of is...

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They're being accused of the problematic aspect of narcissism in a relationship is somebody's grandiosity. So their entitlement, their arrogance, their inability to see other people as an equal. Well, the only way you can be in a relationship as a narcissist and to maintain that position is if you antagonize people. because you need to put people at odds with you. They need to be beneath you.

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They need to be aware that there's a hierarchy in the relationship that you are, whatever the case may be, smarter, better. They need to be above. There's no such thing as equality in a relationship where one person is truly narcissistic.

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So yeah, so antagonism is actually the big bull that a lot of the other traits that we often hear about, they actually are falling under the category of antagonism. What else is in the cluster? We have hostility. So people that kind of tend to hold like a contempt or a spite towards others to where they're not actually collaborating to make relationships better. They're resentful of the person.

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They might envy the person. They might be jealous of the person. So they're hostile towards them. And again, this isn't always... being admitted to. They could be smiling and winning favor and ingratiating and being kind to the person all while sabotaging something covertly through their, because as a result of their hostility. So they might be deceptive.

Chapter 3: What are the brain mechanisms behind empathy and self-control?

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Well, I suppose all of us have done some of this some of the time. So when we talk about personality disorders, what we're really talking about is this trait. So we'll just use antagonism because we're talking about antagonism. Is somebody antagonistic in one or two specific contexts? So do they tend to become antagonistic when they're only talking to their mother? And they're an adult, right?

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But no matter how much time goes by, if they go home to the house that they grew up in, they start being antagonistic. Are we talking about that? Because that's kind of a normal thing that we could see in humans. Or is this person all day, every day, plotting to put people at odds with one another because it benefits them in some way for people to not get along?

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They seem to be the common denominator of helping everybody pick up the pieces back together. So there could be some motivating factor why the person operates in an antagonistic fashion all day, every day. We would say that that's more related to um, abnormal or maladaptive personality.

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But if you're antagonistic once in a while with a particular person because you have a history, that's just being human, right? What we're looking for is how much is this pattern interfering with the life of the individual and the lives of other people? Uh, So there's a distinction there, yeah. What's the root of this? What are the root of much of the cluster B disorders? Good question.

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This is an excellent question. So one of the things that is going to put my answer or set my answer apart is most of the people you've probably seen speak about this topic, personality disorders or narcissism, they're going to give you a different answer than I would give you based on what causes it.

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Most people have this idea or have adopted the idea that what causes it is actually childhood adversity or some sort of abuse or situation where the person learns to be this way. Hurt people hurt people. Precisely, yeah. I mean, that's the most common answer you'll get.

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I would fundamentally disagree with that because there's a lot of new research that has come out within the last 20 years even that suggests that a lot of the traits that we use to describe the central features of something like a narcissism are actually just as much, if not more related, to the way somebody is just intrinsically built rather than the things that happen to them.

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So we're gonna go into like the, there's no such thing as a nature-nurture debate because it's always nature and nurture. So there's no such thing as talking about one without the other. But what I've noticed in clinical research and clinical practice and just in my field in general is there is a lack of awareness among professionals

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of how much DNA and biology contribute to narcissistic traits and features across the lifespan in an individual, regardless of what has happened to them in early life and childhood. So what I mean by that is there is evidence to demonstrate that people can be highly narcissistic or have a personality disorder that's more severe than we'll say mild or moderate.

Chapter 4: What are the characteristics of cluster B personality disorders?

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if you're saying uh trauma doesn't necessarily cause people to become abusers that you can have a child who goes through a horrendous childhood and doesn't grow up to become a narcissist or an antagonist or whatever um and you can also have a childhood which doesn't have abuse and the child does grow up to become an adult or even in childhood is presumably you get narcissistic children as well um

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How often do you see somebody that becomes, let's just say a narcissist or antagonist that doesn't have it in their family history where you have been able to separate out some of the heritability component of this? How many people can environment themselves into a cluster B disorder? Yeah, that's such a great question. Um,

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I would say historically in the mental health field, the answer to that question would be as many people as possible because they're operating from this theoretical lens, right, that these are created, these are designed disorders. They're not built into anybody. They're strictly environmental.

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So that presents a problem if they're strictly environmental to my perspective because what it's saying is that under the right circumstances, you can make a narcissist, right? So to answer your question, maybe I'm... Correct me if I'm not answering your question. I would say it... I'm not going to say something's not possible.

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So do I think it's possible that somebody based on experience alone could develop what we would typically refer to as like a narcissistic personality disorder? Could they meet that criteria at some point in their life? Yeah, sure. I would caution to say though, that what we're really seeing now though, is they need the

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they need enough of the startup material of narcissism in order for it to really manifest into like a pervasive disorder. Meaning there has to be some biological and genetic underpinnings to set up the trade profile for that. They need the raw materials. Yeah, I'd say so. I don't think you could just create it from the ground up in anybody. So do you often see it in mom or dad or grandparents?

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Have you ever looked at this? Has anyone done this study? Yeah, so they're actually, what gives us the most information on how genetic something is versus how environmental is twin studies. Twins, it's a natural experiment. You take two identical twins that have been raised apart, so they don't even know the other exists and they know nothing about their environment.

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You study them later in life or at intervals of life. How similar are they if they come from completely different upbringings completely different socioeconomic status, completely different countries. How similar are they in personality if they didn't know the other exists but they share 100% of their DNA, right?

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So those are the kind of cool natural experiments we can do on identical twins to see how much of the environmental influence is there versus how concordant are their traits, even if they live apart but just share similar DNA. What we found in some pretty landmark meta-analyses and landmark studies is across the board, when it comes to psychological traits...

Chapter 5: How do narcissists use charm and seduction to manipulate others?

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That's drinklmnt.com slash modern wisdom. What about the neurobiology of this stuff? What parts of the brain are involved in empathy and self-control? Have we looked at the brains? Is it dopamine overload? Is it that the amygdala is firing too much? What's going on?

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This is something that I think is extremely important to bring to this conversation because I think oftentimes psychology stops at social and emotional

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know caregiving contributions right like the the original environment and things like that but there are so many other systems involved in creating a personality or creating a trait and you mentioned some of them so we're talking about um hormonal systems the endocrine system um you know, the nervous system and then all of the brain networks that are communicating.

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I don't, I don't really like to say that this is like, there's such a thing as like a narcissistic brain where there's certain regions that look a certain way. And so that's a narcissistic brain. Um, That's a little too naive, I would say. But are there regions or areas in the brain that are indicative of things like a lack of empathy? Sure, absolutely. We see that in certain brains.

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We see that in brain imaging. We also see structural and functional differences in brains pre and post therapy in individuals with personality disorders. They've done studies on child brains. They scan them prior to treatment and then scan them following treatment.

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for tasks related to cognitive restructuring, mentalization-based treatment, and seeing that the function and structure of the brain does in fact change with certain interventions. Okay, so this is not a complete lock-in. We can't intervene. In some cases, yeah. Well, I would say in a lot of cases, none of this is deterministic.

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It's probabilistic, and it's more influential than it is just set in stone. But there are cases, I just want to be totally transparent, there are cases of individuals where there's not much hope for changing the operating system. And what does that look like from a brain chemistry perspective? What differences in brain chemistry could make someone more prone to dominance or aggression?

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Yeah, great question. So what we see, we see proactive or intentional forms of aggression in individuals who have less... activation when it comes to fear learning or consequences. So what I mean by that is some brains operate in a way where they don't learn from mistakes through fear. The fear doesn't register when they do something pretty horrific.

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So there's no motivation to stop doing the behavior when the fear doesn't kick in. There's also no arousal in the body or in systems that would normally say, okay, we need to be a bit hypervigilant here. We just did something. We don't like the way it feels. In some individuals, those things don't happen. So they don't learn from the mistakes.

Chapter 6: What are the differences between grandiose and vulnerable narcissism?

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It's not just exclusive to therapy, but it's important to notice that it's happening in therapy because it gives you a lot of information as far as what's happening in the interaction. I mean, transference in the simplest terms is the feelings that are transferred onto the therapist by the patient.

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Countertransference are some of the feelings or emotional reactions that take place inside of the therapist while they are interacting with the patient. So the reason why that's relevant is because we get to ask cool questions like, would I have been feeling this if I were sitting with anyone else right now?

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Or is this feeling that just got activated in me, is it directly related to the dynamic of this experience?

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of this person that I'm interacting with because it starts to tell you information about how maybe other people are experiencing them outside of therapy in their personal life that maybe they're not super aware of and they might actually, even a narcissist could genuinely come into a therapy office and not have a clue why everybody thinks they're so insensitive. right?

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All the while, the therapist is picking up on their insensitivity and having a counter-transference reaction to this insensitivity. Like, gosh, it feels hard to sit in a room with this person. I feel incompetent. I feel scared. I feel different than I did before they showed up, right? So it's really important, but

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The typical counter-transference that results when you're sitting with somebody who meets the criteria for cluster B, or I should say, yeah, typical or common counter-transference. So what the therapist feels in the room with them is you feel, I said a couple of them just now, oftentimes you just start to overwhelmingly feel incompetent.

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Like you don't know how to do your job or you're not qualified to do your job. And remember, this is just coming as you're sitting with someone. You weren't thinking about it earlier today on the drive to work. You were thinking, oh, I can't wait to go to work. I do a pretty good job. I have a full practice. Then this person comes in and all of a sudden you feel like you can't do your job.

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What is it? What are they doing? They're devaluing you and not telling you that they're devaluing you. But you're starting to feel incompetent. So this is something that somebody with pretty severe personality pathology can sort of just put into the environment. They can export this out into the environment without saying a word. Do you think they mean to?

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Is this an outcome that they want or is this a spandrel that's come along for the ride? So earlier you were asking about purpose evolutionary perspective I would say this is an evolutionary perspective that would be important to look into can they put this spell into the environment into the air for some sort of a

Chapter 7: Can people genuinely in emotional pain still choose to hurt others?

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So disorders that operate around fear and anxiety being like the central feature rather than drama or erratic or dangerous, which is what we would

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typically how we typically describe the cluster b's what would a commonly understood term be for people who are cluster a what would a commonly under the term be yeah you know you're talking about narcissist and uh okay um like paranoid or um okay yeah yeah yeah yeah or um schiz schizoid or schizoid is interchangeably pronounced that way um The other cluster A is schizotypal.

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So we have schizotypal, schizoid, or schizoid and paranoid are the cluster A's. And then the cluster C's are the avoidant, the dependent, and the... I'm drawing a blank here as I'm on the spot. What's the third... What's the third cluster C? Obsessive compulsive personality disorder. Avoid it. Obsessive compulsive personality, which is completely different than OCD. Those aren't the same. Okay.

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So when we look at cluster A, cluster B, and cluster C, do these fit on the spectrum? If you were to make a 3D or a 2D graph of how the clusters sit together, does that exist? Or are these completely different universes? Yeah.

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So they're not completely different universes because the problems that they create in the individual and in the individual's relationships are directly related to who the person characteristically is. So in cluster A's, these individuals are characteristically odd and eccentric. Okay. In cluster Bs, they're characteristically dramatic, erratic, dangerous, and severe interpersonally.

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And then in the cluster Cs, they're characteristically fearful and anxious. So all their relationships operate based on those types of motivations or intrinsic perceptions. Okay, that's interesting. All right, going back to the sort of nature-nurture debate, why is the idea that hurt people hurt people so attractive?

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What makes that such a seductive explanation if behavioral genetics and Robert Plowman and a couple of fucking million people from the biobank can explain otherwise? Well, I think one is because the work of Robert Plowman, this isn't a conspiracy theory.

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I mean, it's been admittedly swept under the rug in academic circles and clinical circles because it seems to really intimidate people that there might be, like, strategy and patterns to, to what we have decided is a negative behavior at this point in our, in our evolution, right?

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That, that the, that the, um, that the negative behavior could potentially come naturally or be ingrained, um, is terrifying for people to accept. So what they've done instead is created this idea that everything, um, is environmentally determined. So the reason why there's a preference for that is if the environment created it, maybe the environment can stop it, prevent it, or modify it.

Chapter 8: What are the best strategies to protect yourself from narcissistic manipulation?

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No, narcissism is excessive investment in one's image, the image that they prefer. It's excessive investment in that preferred image at the expense of any authentic self. So it's not that... They have low self-esteem in this void of shame, which is the most common idea.

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I can direct you to behavioral geneticists and evolutionary psychologists that can blow that theory out of the water if you want. But it's not a shame-based disorder. It's excessive investment in one's preferred image at the expense of cultivating a true self. So yeah, they get hurt and wounded and offended and defensive, and they get triggered by

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and they get injured because they haven't cultivated anything to receive a disagreement underneath that thin layer of reflection that's on the pond that narcissus is gazing at. There's nothing under there because nothing has been examined or cultivated. So it's like they're emotionally thin-skinned, but it's not because of shame. It's because they didn't

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put any emotional muscle underneath any of that um but they prefer to be the way they are i think this really bothers people why would anybody prefer to be someone who doesn't get along with anybody they're entitled they don't believe in equality so in a way they expect not to get along with anybody because everybody has to accept that they are better than them in order for them to get along with everybody um

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Somehow, this got morphed into this idea that it's all compensatory, that it's all compensation for low self-esteem. Those are just theories, based, by the way, on the reports of the narcissists telling professionals that. Perhaps an unreliable self-witness. Perhaps. Before we continue, I am a massive fan of reducing your alcohol intake, but historically, non-alcoholic brews taste like ass.

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Right now, you can get 15% off your first online order by going to the link in the description below or heading to athleticbrewing.com slash modernwisdom. That's athleticbrewing.com slash modernwisdom. difference between vulnerable and grandiose narcissism? Does this show up? Because I know these terms.

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I can pretend that I know what I'm talking about with narcissism, but is that bullshit or is that clinically validated? I'm sure you know exactly what they are. A grandiose narcissist is somebody who you see their grandiosity overtly, meaning they're not concealing it. Vulnerable narcissism, depending on who you ask, one definition of vulnerable is... They're concealing their vulnerability.

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